New material for Final Part 1

Question 1

What is the term for an infection of the skin, subQ fat, or connective tissue?

Answer 1

cellulitis

Question 2

What is the term for infection of bone marrow?

Answer 2

osteomyelitis

Question 3

What is septic arthritis?

Answer 3

infection of a joint (synovial tissue, articular surfaces)

Question 4

What are the 4 “S” Joints that are most prone to infection?

Answer 4

spine, SI, symphysis pubis and sternoclavicular

Question 5

What is the most common organism responsible for infection?

Answer 5

Staph Aureus (90%)

Question 6

T/F: Heel sticks in infants, pneumonia, and UTIs are common modes of infection.

Answer 6

True

Question 7

What is the mot common route of dissemination?

Answer 7

hematogenous

Question 8

T/F: Infants and young children with acute infections will show decreased ESR levels.

Answer 8

False; increased

Question 9

Describe the infantile pattern of vascular anatomy in infected bones.

Answer 9

metaphyseal and diaphyseal vessels may penetrate the physis (septic arthritis and osteomyelitis)

Question 10

T/F: In adults with bone infections, metaphyseal vessel penetrate the vanishing physis, reestablishing communication with the subarticular bone end.

Answer 10

True

Question 11

T/F: Growth plates inhibit the spread of infection but only those that spread hematogenously.

Answer 11

true

Question 12

MC areas for venous stasis?

Answer 12

Knee, hip, ankle (distal tibia), shoulder,and spine

K HASS

Question 13

Who is most likely to get venous stasis?

Answer 13

elderly and diabetics

Question 14

2 major categories of infections?

Answer 14

suppurative (pus) and non-suppurative (TB)

Question 15

What is the term for a bone marrow infection by a (pyogenic) non-tubercular organism which is most commonly caused by Staph Aureus?

Answer 15

Suppurative Osteomyelitis (anything BUT TB)

Question 16

What other organisms may cause suppurative osteomyelits other than Staph Aureus?

Answer 16

Strep. Pneumoniae, E. Coli, and Pseudomonas

Question 17

Edema, lymphadenopathy, warm skin, cellulitis, and joint pain. What does this sound like?

Answer 17

acute infection

Question 18

What are the 4 radiographic stages of bone infection?

Answer 18

Latent/hidden stage (1-10 days)
Early stage (10-21 days)
Middle stage (weeks)
Late Stage (weeks)

Question 19

At which radiographic stage of bone infection will you see osteopenia and soft tissue edema which make the infection resemble tumors?

Answer 19

Early stage (tumors and infections both push fat/fascial planes out of place but this resolves over time with infections as the soft tissue planes are obliterated)

Question 20

At which radiographic stage of bone infection will you see a periosteal response and/or a solid codman’s triangle?

Answer 20

Middle stage

Question 21

At which radiographic stage of bone infection will you see permeative or lytic moth-eaten destruction (that may cross anatomical barriers)?

Answer 21

Middle stage

Question 22

What are the 3 patterns of one destruction?

Answer 22

geographic, moth eaten, and permeative

Question 23

What pattern of bone destruction is usually the least aggressive, slow-growing, has a short zone of transition, and typically has a well-defined margin?

Answer 23

Geographic

Question 24

Which pattern of bone destruction is moderately aggressive, has a longer zone of transition than geographic, a poorly defined margin, and consists of numerous small holes?

Answer 24

Moth-eaten

Question 25

Which pattern of bone destruction consists of numerous very small lesions (almost imperceptible on plain film) and is the most aggressive pattern?

Answer 25

Permeative bone destruction

Question 26

T/F: Permeative bone destruction has a wide zone of transition and is poorly demarcated.

Answer 26

True

Question 27

At which radiographic stage of bone infection will you see cortical destruction, draining sinus, involucrum, and/r cloaca?

Answer 27

Late stage

Question 28

At which radiographic stage of bone infection will you see sequestrum, sclerosis, ankylosis, and/or a loss of joint space?

Answer 28

Late Stage

Question 29

What is the term for a chalky white area representing isolated dead bone (cortical and medullar infarcts)?

Answer 29

sequestrum

Question 30

What is the term for a chronic periosteal response aka “bony collar?” This is created as pus lifts the periosteum and causes new bone formation, trying to wall off the infection.

Answer 30

Involcrum

Question 31

A rare complication of cloaca(s) is to develop a squamous cell carcinoma within the channel of the cloaca. What is the malignant ulcerative channel called?

Answer 31

Marjolin’s Ulcer

Question 32

What localized, aborted form of suppurative osteomyelitis produces localized pain which is worse at night and relieved by aspirin? This formation also mimics osteoid osteoma on xray but is less than 1 cm.

Answer 32

Brodie’s abscess formation

Question 33

Where are Brodie’s abscess formations typically located?

Answer 33

metaphyseal location, especially distal tibia